Suggest Treatment For A Retractile Testis Along With Issues Of Erectile Dysfunction

Posted on Fri, 15 Nov 2019

Question: Hi Dr
I have been dealing with an issue in regards to my left testicle. I was recently diagnosed with low T (241) and am on Clomid 50 mg eod. My left testicle is slightly smaller than the right however it seems to retract higher especially when I am ejaculating to the point where it goes up into my pelvis. It always comes back down after thankfully. I had a check up and the doctor just said it’s my anatomy changing. The testicle has been retracting like that for about 6 months now. I was wondering if it’s possibly a varicocele? This retracting also coexists with ED and unable to maintain an erection the whole time. Strangely I am sometimes able to ejaculate with a flaccid penis. To give you a brief idea of my history, I used to take Propecia for 10 years, 30 years old, currently take Zoloft, lamictil, adderall, Wellbutrin and viagra before sex. Do you have any ideas? Overactive cremaster muscle?

Answered by Dr. Manuel C See IV (12 hours later)

Brief Answer:
You may have retractile testis and strong cremasteric.

Detailed Answer:

Hi,

You have a retractile testis and it is because of a very strong cremasteric muscle. If you see some dilated veins in the testis then you may also have varicocoele. Varicocoele is best diagnosed with an ultrasound objectively.

The medications you took like Zoloft etc contributes to your erectile dysfunction and low testosterone. Clomid would help with sperm production and may stimulate improve testosterone production.

Hope I have answered your query. Let me know if I can assist you further.

Regards

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Manuel C See IV (8 minutes later)

Thank you! Another question. Is there a reason all of a sudden in my adulthood I developed both of these or any identifiable probable causes?

Answered by Dr. Manuel C See IV (11 minutes later)

Brief Answer:
Medications and small testis.

Detailed Answer:

Hi,

The effects of the medications slowly piles up that is why it more significant now than before. Also the smaller testis produces less testosterone there you aggravating your problem also.

Hope I have answered your query. Let me know if I can assist you further.

Regards

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Manuel C See IV (22 minutes later)

Is it possible for this to be reversed either with Clomid and/or discontinuing Zoloft/decreasing dosage of meds? Obviously I will not do this unless I speak to my prescribing physician.

Answered by Dr. Manuel C See IV (3 minutes later)

Brief Answer:
Yes could be reversed.

Detailed Answer:

Hi,

Yes it would be reversed if medications are stopped or decreased in dosage. Clomid would help but if the medications are still on board then you may still have the symptoms. I suggest you talk to the prescribing doctor about side effects.

Hope I have answered your query.

Regards

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Above answer was peer-reviewed by : Dr. Remy Koshy